I wrote previously about how I only seem to get 4.5 to 5 hours a night of good sleep before an uncomfortable period of intermittent waking/sleeping. This is, to a large part, a result of my having developing tolerance to my sleeping pills. I've been taking Zopiclone for a few years now - that's Lunesta in the U.S. When I started, I got a good 7 hours of sleep straight. I knew that if I had enough hours in bed, I was going to feel refreshed in the morning. But  now all I get is that lousy 5 hours max on a single pill. When I wake up, it's a crap shot if I'll fall back asleep or not. In the last few days, I crapped out and as a result my days have been like walking through a fog.

Now, if I take another half a pill at 5 in the morning or whenever I wake up, that usually does the job. But I'm concerned about developing tolerance to that routine too. Plus my Zopiclone prescription is only for one a day and my doctor has already hinted that if I'm needing more pills, not less, then maybe he'll stop it all together, which totally terrifies me because then I'll be back where I was before all this, not sleeping at all.

This is getting to be a real bummer. Does anyone have any suggestions on how to cope with or even reverse sleeping pill tolerance?

My sleep has been not terrible this last week thanks to a change my doctor made in my latest cocktail of sleeping, anti-depression and anti-anxiety pills. I've been able to fall asleep OK, but then I wake up about 4:00 AM and start a period of intermittent sleeping followed by waking followed by sleeping. This goes on for several hours, such that it seems I'm awake the whole time but I know I must be sleeping too. Because if I get into bed around midnight and can stay in bed until about 9:30 AM, I feel refreshed, like I've gotten a full night's sleep. My guess is I'm sleeping to waking ratio during these hours is about 50/50.

Obviously, this isn't the most productive way to start the day. I'm lucky that I work at home and I can flex my hours however I want. But if I had to get to a job - or when we go on vacation - it can be tough for me to get the sleep I need when I need so many hours in bed.

What's particularly weird, though, is the dreams I have during this sleeping-waking period! They all seem to be stressful someone's-coming-to-kill-me or I'm in a scary place and I want to get out or I'm with someone who's making me jittery. Imagine 4-5 hours of unpleasant quasi-nightmarish dreams and you've got my experience.

My doctor says he thinks I've still got left over anxiety and/or depression in the early morning hours after the half-life of my latest pills have worn off. He's suggested I pop another pill to see if that relieves the bad dream symptoms. I'll let you know.

Anyone else have this kind of semi-wakeful bad dream experience? I'll post later on how it's going.

-- Brian

The pill my doctor recommended to help cut the anxiety and hopefully temper the early morning bad dreams is Mobiclomede (brand name Mobimede). It's a very old fashioned anti-depressant from the 1950s and 60s, known as a MAO Inhibitor. Most people have since graduated to newer meds like SSRIs and SNRIs, but for me the side effects were too great and I stopped using the more modern concoctions. Going to an "old" drug like this is kind of like a last resort - when nothing else works.

So far, it seems to be doing OK. I'm certainly feeling less depressed during the day and after upping my dose as I mentioned in a previous post, my early morning nightmares seems to be less, though my pattern of wake/sleep/wake/sleep is still there (maybe that's just my natural pattern?)

Last night, we had a parent-teacher meeting for my son. I usually take my third Mobimede of the day around dinner time, but this night I forgot. We didn't get home until 10:00 PM and I wasn't sure what to do - take the pill anyway or skip a night. The reason to skip a night was that the pill *may* have an activating component to it that could keep me up. The doc wasn't sure but many anti-depressants act this way. On the other hand, skipping the pill might have meant a return to bad dreams in the morning, and I've been hoping to break that pattern.

So I took it. And guess what...I couldn't fall asleep until 3:30 AM. I tossed and turned and maybe fell asleep a little. But when I got out of bed for the fourth or fifth time to use the bathroom, I gave up and took another half a Zopiclone and that knocked me out until 7:00 AM. I then had another two hours of on and off again sleep but no really bad dreams.

If I have this situation again, I think I'll skip the 10:00 PM shot though.

You know the old saying “time is money?” Well, how much would you say time spent sleeping is worth? As I found out on a recent family vacation: exactly $119 plus tax.

We were driving down the California coast from San Francisco to San Diego, stopping for the night at inexpensive motels. Our first night was in Monterey and I had picked a shabby but inexpensive Days Inn not far from the city’s fabled Fisherman’s Wharf and its lively restaurant and entertainment district. We picked up the key from the dour clerk in the motel’s perfunctory lobby.

In order to keep our costs low, we all cramped into a single room with two queen beds and a rollaway. How do you fit five people into three beds? Boys with boys, girls with girls. That meant that instead of my wife Jody and I sharing a bed, Jody shared with thirteen-year-old Merav while I had a choice between either fifteen-year-old Amir or eight-year-old Aviv.

Given that Amir is over six feet tall, I opted for the much shorter and (I thought) manageable little Aviv.

Unfortunately, as I soon discovered, Aviv is also a night kicker and a squirmer and a won’t-stay-on-his-side-of-the-bed kind of restless sleeper. Not long after I had crawled into bed (several hours after Aviv had already fallen asleep) then – ouch! – Aviv whacked me in the face with his arm as he flailed in deep REM. A few minutes later and – yow! – his leg was in my groin.

He was also, by this point, hogging at least two-thirds of the bed. I tried to move him back to “his side” but he kept squirming his way towards me.

Now, I’m not a good sleeper to start with. I've written previously about my ongoing battle against chronic insomnia. In that post I reported that I was starting to lick my sleeping difficulties with a cocktail of sleeping pills and behavioral techniques. Many meds later, that’s still mostly true, but I’m very finicky about my sleeping conditions. And getting whacked in the face very three minutes simply wasn’t very conducive.

I knew I had to somehow separate myself from Aviv. But how? First I pulled the bedspread and the blanket off of the two of us and wrapped one around Aviv and the other around my own body, creating a sort of double cocoon. No luck:  he quickly kicked that free.

Next, I went into the bathroom and took out all of the towels there in an attempt to create a fence between us. He got through that too.

I briefly considered putting Aviv on the floor on the pillow cushion from the big armchair that sat n the corner. But that seemed too cruel – after all, he wasn’t doing anything on purpose. And he’d probably fall off, wake up and cry and as a result I’d wind up staying awake worrying about when he’d be falling off.

Sleeping in the armchair myself was out of the question: I can’t sleep on planes, why would it be any better in a shabby motel in Monterey?

Mind you, that all of this maneuvering, both mental and physical, was being undertaken under the influence of a very strong sleeping pill, which, while not enough to allow me to sleep between beatings, still put me into an extra irritable haze.

I resolved not to sleep at all. I’d pull an all nighter and finish my book. It was now 2:00 AM. Only four hours until the sun came up and I could go for a run to pump a little much needed adrenaline into my system. But that plan ultimately seemed foolish. We had a busy day planned with a trip to the Monterey Aquarium made famous in the Sharon Stone/Albert Brooks film “The Muse,” followed by a three hour drive down the coast to our next stop near Hearst Castle.

My groggy mind raced through alternatives. Maybe we could cram another rollaway bed into the already tight room. Or maybe I could bed down in a spare room in the motel. Yes, that was the ticket. I pulled on my jeans and a sweatshirt and headed to the lobby.

It was locked. A sign said to call the following number for help. As I imagined waking up the proprietor of this dingy place in the middle of the night, I thought better of this approach.

Earlier in the evening, I had taken a stroll with the kids downtown and we had stopped in at another hotel to ask directions. The desk staff at the Casa Munras was positively chipper and told me that they prided themselves on their excellent customer service.

I got in the car. The light in the lobby of this second hotel was thankfully still on. I explained my plight to the man at the desk and asked as plaintively as I could that, as it was now 2:30 AM, could he possibly sell me a room for just a few hours at a discounted rate? To the desk man’s credit, he took me at my word rather than making the obvious assumption that I was up to some nefarious nighttime activity.

His cheapest room with a single bed ran $119 for the night plus various taxes, leading to a grand total of $139. While he wouldn’t give me a break on the price, he graciously offered to upgrade me to a king at no extra cost. It was an awful lot of money for so little time. I considered sleeping in my car, or maybe heading down to the beach.

In the end I took it. The bed in the new room was downy and delicious. I was ready to crash immediately. But first, I wrote a note out for Jody telling her where I was, drove back to the Days Inn and slipped the note under the door, before returning to the Casa Munras. It was now 3:00 AM. I took another sleeping pill and gratefully climbed into bed....alone.

I awoke at 8:30 AM with no idea where I was but feeling remarkably refreshed. As soon as I remembered the night’s events, I called Jody on the phone. She assumed I’d gone out for an early morning run…a long time one but not impossibly so. She hadn’t even seen my note! I ate the continental breakfast at the new hotel – why not it was paid for – then came “home” to pack up for the day’s drive.

I felt calm and rested, my decision seemed validated, a bargain even. Because at the end of the day – or in the middle of the night –  there’s no price on a good night’s sleep.